Individual provider Active NPI

Dianilda Santiago, DMD

  • General Practice Dentistry
  • Arecibo, PR
National Provider Identifier
1790809937
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1924 Issued in PR
Practice address
HC 2
Arecibo, PR 00612-9073
Phone
(787) 817-2081
Fax
(787) 817-2081
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1924 PR Primary

Addresses

Primary practice location

HC 2
Arecibo, PR 00612-9073

Mailing address

HC 02 Box 17294 Carr Municipal
Arecibo, PR 00612
Phone (787) 817-2081

Other identifiers 1

IdentifierTypeStateIssuer
1425787OtherPRDRIVER LICENSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160204000453 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1951605419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790809937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 02 BOX 17294 CARR MUNICIPAL",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-817-2081",
            "fax_number": "787-817-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 2",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006129073",
            "telephone_number": "787-817-2081",
            "fax_number": "787-817-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "DIANILDA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSING",
            "identifier": "1425787",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

Verify at the official NPI Registry.